Solid breast lesions: Evaluation with Power Doppler US

PURPOSE: To evaluate power Doppler ultrasound (US) in detection of vascularity of solid breast lesions and to correlate patterns of vascular distribution with histopathologic findings. MATERIALS AND METHODS: Eighty-six solid breast masses, which were subsequently sampled for biopsy, were studied with gray-scale and power Doppler US. Patterns of vascular distribution were assigned before biopsy. RESULTS: There were 25 cancers, 38 fibroadenomas, and 23 other benign lesions. Seventeen (68%) cancers had penetrating vessels, four had peripheral vessels, and four had no vessels. Power Doppler US depicted no vessels in 21 fibroadenomas, peripheral vessels in 15, and penetrating vessels in two. Other benign lesions included 11 with no detectable vessels, nine with peripheral vessels, two with central vessels, and one with penetrating vessels. By using penetrating vessels to indicate malignancy, sensitivity for power Doppler US was 68%, specificity was 95%, positive predictive value was 85%, and negative predictive value was 88%. Two cancers were found to be malignant with power Doppler US only. CONCLUSION: The pattern of distribution and morphology of blood vessels in solid breast masses seen at power Doppler US is a potentially important feature to be considered along with other sonographic criteria to predict the likelihood of malignancy.